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Symptomatic treatment of unstable angina in addition to standard therapy, long-term therapy for vasospastic angina (Prinzmetal’s angina); acute left ventricular heart failure of various etiologies (weakness of the heart muscle with dysfunction of the left ventricle); acute myocardial infarction.
Dosage & Administration
Dosage should be individualized for each patient. Treatment should start with a low dose and gradually increase to the desired. Recommended dose – 2-7 mg / h. In some cases, the dose can be increased to 10 mg / hr. For heart failure patients require higher doses – in some cases up to 50 mg / hr. The average dose is ≈7,5 mg / h.
Concentrate Iso-Mika 1 mg / ml should be injected in soluble form / in infusion with automatic infusion systems (or at least in the form of drip infusion), in a hospital under constant monitoring of indicators of the cardiovascular system.
For the preparation of p-ra concentration of 100 ug / ml (0.01%) – 50 ml of the concentrate Iso-Mika 1 mg / ml (5 ml ampoules 10) should be diluted in 450 ml of p-ra isotonic sodium chloride solution.
For the preparation of p-ra concentration of 200 ug / ml (0.02%) – 100 ml concentrate Iso-Mika 1 mg / ml (10 to 10 ml vials) should be diluted in 400 ml of p-ra isotonic sodium chloride solution.
Depending on the clinical, hemodynamic and ECG, the treatment can be extended to 3 days. During treatment requires monitoring of the following indicators:
– BP (not less than 100 mm Hg..);
– ECG monitoring;
– Heart rate;
– Diuresis (catheter).
Hypersensitivity to nitrate compounds; acute circulatory failure (shock, circulatory collapse); severe hypotension (systolic blood pressure <90 mm Hg..); hypertrophic obstructive cardiomyopathy, constrictive pericarditis and pericardial tamponade; cardiogenic shock, if not possible correction of left ventricular end-diastolic pressure via intra kontrapulsatsii or drugs with positive inotropic effect; recently transferred craniocerebral trauma or hemorrhagic stroke; severe anemia, chronic pulmonary edema, angle-closure glaucoma, hyperthyroidism.
Particularly close medical supervision is necessary when:
– Acute myocardial infarction with low filling pressure (avoid lowering systolic blood pressure below 90 mm Hg..);
– Aortic and / or mitral stenosis;
– Diseases accompanied by increased intracranial pressure.